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Medical Principles and Practice :... 2020The purpose of the present study was to determine the local recurrence rate, risk of dedifferentiation, and distant metastasis after surgical excision of intramuscular...
OBJECTIVE
The purpose of the present study was to determine the local recurrence rate, risk of dedifferentiation, and distant metastasis after surgical excision of intramuscular lipomas (IML) and atypical lipomatous tumors (ALT).
SUBJECTS AND METHODS
We retrospectively assessed all IML and ALT surgically removed from the extremities or trunk wall in our clinic between 1997 and 2006. Data from 141 patients with IML and 35 patients with ALT were extracted from the National Pathology Registry and patient files.
RESULTS
IML and ALT recurred in 10 and 6 tumors, respectively. No metastases were observed in either group. The 5- and 10-year local recurrence-free survival rates were 97.1% (94.3-99.9) and 94.8% (CI: 91.1-98.6) for IML and 84.6% (CI: 72.1-97.1) and 81.1% (CI: 67.6-94.8) for ALT, respectively. ALT were found to dedifferentiate in 2/35 cases.
CONCLUSION
Both IML and ALT showed a low recurrence rate when removed surgically from the extremities or trunk wall with intended marginal resection. No distant metastases were observed in any of the groups. It, therefore, seems safe to treat these tumors with marginal resection.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Child; Child, Preschool; Extremities; Female; Humans; Lipoma; Liposarcoma; Male; Middle Aged; Muscle Neoplasms; Neoplasm Metastasis; Neoplasm Recurrence, Local; Retrospective Studies; Torso; Tumor Burden; Young Adult
PubMed: 31550705
DOI: 10.1159/000503621 -
AJR. American Journal of Roentgenology Jan 2012The purposes of this review are to describe the principles and method of MR spectroscopy, summarize current published data on musculoskeletal lesions, and report... (Review)
Review
OBJECTIVE
The purposes of this review are to describe the principles and method of MR spectroscopy, summarize current published data on musculoskeletal lesions, and report additional cases that have been analyzed with recently developed quantitative methods.
CONCLUSION
Proton MR spectroscopy can be used to identify key tissue metabolites and may serve as a useful adjunct to radiographic evaluation of musculoskeletal lesions. A pooled analysis of 122 musculoskeletal tumors revealed that a discrete choline peak has a sensitivity of 88% and specificity of 68% in the detection of malignancy. Modest improvements in diagnostic accuracy in 22 of 122 cases when absolute choline quantification was used encourage the pursuit of development of choline quantification methods.
Topics: Algorithms; Biomarkers, Tumor; Bone Neoplasms; Choline; Contrast Media; Humans; Image Interpretation, Computer-Assisted; Magnetic Resonance Spectroscopy; Muscle Neoplasms; Protons; Reproducibility of Results; Sensitivity and Specificity
PubMed: 22194493
DOI: 10.2214/AJR.11.6505 -
BMJ Case Reports Jan 2021A 42-year-old man presented to the gastroenterology clinic with features of gastric outlet obstruction, significant weight loss, anaemia, ascites, and pain in the lower...
A 42-year-old man presented to the gastroenterology clinic with features of gastric outlet obstruction, significant weight loss, anaemia, ascites, and pain in the lower back and left thigh. CT scan of the abdomen and pelvis showed wall thickening in the antropyloric region of the stomach and enhancing soft tissue lesion in the left psoas and right gluteal region. Gastroscopy revealed a circumferential growth in the antrum and pylorus of the stomach, and biopsy from the growth was reported as moderately differentiated adenocarcinoma. Positron emission tomography-CT scan showed multiple skeletal muscle metastases all over the body. Fine-needle aspiration cytology and immunohistochemistry from the psoas lesion confirmed metastatic adenocarcinoma deposits. He underwent antropyloric stenting for his obstructive symptoms and received supportive care, finally succumbed to his illness after 6 weeks.
Topics: Adenocarcinoma; Adult; Humans; Male; Muscle Neoplasms; Muscle, Skeletal; Stomach Neoplasms
PubMed: 33462054
DOI: 10.1136/bcr-2020-239518 -
PET Clinics Oct 2018Soft tissue sarcomas (STSs) account for less than 1% of adult solid tumors and about 7% of pediatric malignancies, causing 2% of cancer-related deaths. With the advent... (Review)
Review
Soft tissue sarcomas (STSs) account for less than 1% of adult solid tumors and about 7% of pediatric malignancies, causing 2% of cancer-related deaths. With the advent of PET-computed tomography (CT), the value of (18) fluorine-2-fluoro-2-deoxy-d-glucose (FDG) PET imaging to improve the management of STSs has been explored. FDG PET imaging has been found useful in restaging and treatment response assessment. This article reviews current knowledge and application of FDG PET-CT in initial diagnosis, staging, restaging, treatment response monitoring, and prognosis, with a brief overview of the most common histologic subtypes of STS.
Topics: Bone Neoplasms; Fluorodeoxyglucose F18; Humans; Muscle Neoplasms; Neoplasm Staging; Neoplasms, Connective and Soft Tissue; Positron Emission Tomography Computed Tomography; Radiopharmaceuticals; Sarcoma; Treatment Outcome
PubMed: 30219191
DOI: 10.1016/j.cpet.2018.05.011 -
Cancer Jun 2019Delays from the diagnosis of muscle-invasive bladder cancer (MIBC) to radical cystectomy (RC) longer than 12 weeks result in higher mortality and shorter...
BACKGROUND
Delays from the diagnosis of muscle-invasive bladder cancer (MIBC) to radical cystectomy (RC) longer than 12 weeks result in higher mortality and shorter progression-free survival. This study sought to identify factors associated with RC delays and to determine whether delays in care in the current treatment paradigm, which includes neoadjuvant chemotherapy (NAC), affect survival.
METHODS
Subjects with American Joint Committee on Cancer stage II urothelial carcinoma of the bladder who underwent RC from 2004 to 2012 were identified from the linked Surveillance, Epidemiology, and End Results national cancer registry and the Medicare claims database and were stratified into RC groups with or without NAC. Cox multivariable proportional hazard models and multivariable logistic regression models assessed the significance of delays in RC for survival and identified independent characteristics associated with RC delays, respectively.
RESULTS
This study identified 1509 patients with MIBC who underwent RC during the study period. In comparison with timely surgery, delays in RC increased overall mortality, regardless of the use of NAC (hazard ratio [HR] without NAC, 1.34; 95% confidence interval [CI], 1.03-1.76; HR after NAC, 1.63; 95% CI, 1.06-2.52). Patients proceeding to RC without NAC had higher odds of delayed care if they lived in a high-poverty neighborhood (odds ratio [OR], 1.37; 95% CI, 1.01-2.08) or nonmetropolitan area (OR, 1.61; 95% CI, 1.01-2.55), were men (OR, 2.22; 95% CI, 1.25-4.00), or required a provider transfer for bladder cancer care (OR, 1.82; 95% CI, 1.10-3.03).
CONCLUSIONS
Delays in care from the time of either the initial diagnosis or the completion of NAC to RC are associated with worse overall survival among patients with MIBC. Timely surgery is fundamental in the treatment of MIBC, and this necessitates attention to disparities in access to complex surgical care and care coordination.
Topics: Aged; Cystectomy; Female; Follow-Up Studies; Humans; Male; Muscle Neoplasms; Neoplasm Invasiveness; Prognosis; Retrospective Studies; Survival Rate; Time-to-Treatment; Urinary Bladder Neoplasms
PubMed: 30840335
DOI: 10.1002/cncr.32048 -
Technology in Cancer Research &... Aug 2004Combined modality treatment of musculoskeletal tumors led to improved patient survival. As survival improves, more consideration is given to the functional outcome of... (Review)
Review
Combined modality treatment of musculoskeletal tumors led to improved patient survival. As survival improves, more consideration is given to the functional outcome of treatment, and interest is focused on the development of less mutilating and extensive surgery. One modality that can reduce patient disability significantly is cryosurgery, as it allows minimally invasive surgery based on marginal resection and tumor interface sterilization instead of wide resection of certain neoplasms. Classical cryosurgery as developed by Marcove involves pouring of liquid nitrogen into the tumor bed. This approach revolutionized the treatment of some tumors such as giant cell tumor of bone, allowing intra-lesional resection to substitute the wide-resection method used up to that time. However, complications of this method of treatment are common, including nitrogen emboli, fractures of the bone due to extensive necrosis and damage to neurovascular elements. A recent development in the field of cryosurgery has been the argon-based system allowing controlled formation of an ice-ball surrounding a metallic probe. The system is computer controlled and allows precise evaluation of the tumor bed interface as well as surrounding structures that need to be protected. Prior to application of this method in humans it is important to ensure that interface sterilization is indeed achieved using cryosurgery. To evaluate this question, a Swarm rat chondrosarcoma was used. Cell viability was assessed following ice-ball formation. Histological evaluation indicated that cell death occurs up to 5 millimeters from the ice-ball if temperatures of -40 degrees Celsius at the metallic probe are achieved. A further evaluation was performed on samples obtained from patients during surgery. A minimum of two freezing cycles was shown to be necessary to achieve tissue viability similar to that of boiled tissue. Twenty-seven patients were operated to date using an argon-based cryosurgery system. The patients included 7 cases of grade I chondrosarcoma, 5 cases of giant cell tumor of bone, 14 cases of a metastatic lytic bone lesion and a single case of osseous-fibrous dysplasia. None of the patients suffered nerve injury during the operation. After a minimal follow-up period of 2 years only two of the surviving patients had a recurrence (a giant cell tumor of the proximal fibula, and the patient with the osseous-fibrous dysplasia whose tumor recurred as a frankly malignant adamantimoma). There were no pathological fractures. This method appears practical and allows close monitoring of the surrounding tissue to reduce the chances of recurrence.
Topics: Animals; Argon; Bone Neoplasms; Cell Line, Tumor; Cell Survival; Chondrosarcoma; Cryotherapy; Giant Cell Tumor of Bone; Humans; Muscle Neoplasms; Neoplasm Metastasis; Nitrogen; Rats; Time Factors
PubMed: 15270588
DOI: 10.1177/153303460400300407 -
Acta Ortopedica Mexicana 2010Musculoskeletal tumors may be benign, which have a variable and unpredictable behavior pattern, or malignant, which have to be treated promptly and appropriately, as... (Review)
Review
Musculoskeletal tumors may be benign, which have a variable and unpredictable behavior pattern, or malignant, which have to be treated promptly and appropriately, as they are very aggresive. The diagnosis and treatment have changed, as new surgical techniques, biocompatible materials and chemo- and radiotherapy drugs have been added to the therapeutic armamentarium. The current purpose of oncologic orthopedics is to preserve function and its priority is a good quality of life. This paper describes the diagnosis and treatment of these conditions.
Topics: Bone Neoplasms; Humans; Muscle Neoplasms
PubMed: 20831019
DOI: No ID Found -
Annals of Oncology : Official Journal... May 2006Seventy to eighty percent of patients with newly-diagnosed bladder cancer will present with superficial tumors (Ta, Tis or T(1)). There is, however, a continuum between... (Review)
Review
Seventy to eighty percent of patients with newly-diagnosed bladder cancer will present with superficial tumors (Ta, Tis or T(1)). There is, however, a continuum between superficial and muscle-invasive cancer, with the advanced cases usually associated with less-differentiated histology and aneuploidy. Common sites of metastasis include regional lymph nodes, bone, lung, skin and liver. From the low cure rates achieved with radical cystectomy, there is strong evidence that bladder cancer, from the outset, is a systemic disease. The limitations of local treatment are well-documented: a local control rate of 30% with radiation treatment, and 50-70% with radical cystectomy; and no improvement in surgical cure was seen with the use of preoperative radiation. Over the past 30 years, since the initial reports of the effectiveness of cisplatin in the treatment of advanced bladder cancer, there has been a steady flow of chemotherapeutic agents, singly and in combination, shown to be effective in the treatment of this tumor. While response rates and CR rates have increased with the use of combination chemotherapy, this has not translated into survival in advanced disease of greater than 16 months. While the search for more effective agents and combinations continues, attention has also been given to the roles of neoadjuvant and adjuvant chemotherapy in an effort to improve the cure rate achieved with surgery alone. Although radical cystectomy, with continent diversion or neobladder construction in selected cases remains the standard of care in the United States for patients with muscle-invasive bladder cancer, several groups have explored therapeutic strategies that aim at bladder preservation. Early approaches with the goal of bladder preservation consisted of radiation treatment as monotherapy (largely abandoned) or aggressive TURBT for smaller tumors. Over the past 20 years, the Massachusetts General Hospital (MGH) and the Radiation Therapy Oncology Group (RTOG) have studied patients with muscle-invading bladder cancer utilizing tri-modality treatment: a visibly complete transurethral resection followed by radiation with concurrent radiosensitizing chemotherapy and, subsequently, adjuvant chemotherapy. Thus, chemotherapy has been used in two phases of treatment (1) as radiosensitizers, given concurrently with radiation treatment and (2) as adjuvant treatment, recognizing that survival will only be improved by the successful treatment of micrometastases. Based on preliminary information from reports of the effectiveness of gemcitabine/cisplatin in advanced disease, that combination was chosen as the adjuvant regimen in one of our earlier protocols, recently completed and reported. Our current protocol utilizes the Bellmunt regimen as our adjuvant program with the highest RR in advanced disease. This study is ongoing, with early reports of tolerance of the three-drug regimen encouraging. The treatment options for muscularis propria-invasive bladder tumors can broadly be divided into those that spare the bladder and those that involve removing it. In the United States, radical cystectomy with pelvic lymph node dissection is the standard method used to treat patients with this tumor.
Topics: Algorithms; Antineoplastic Combined Chemotherapy Protocols; Biomarkers, Tumor; Chemotherapy, Adjuvant; Combined Modality Therapy; Cystectomy; Humans; Muscle Neoplasms; Neoplasm Invasiveness; Quality of Life; Survival Analysis; Urinary Bladder Neoplasms
PubMed: 16807436
DOI: 10.1093/annonc/mdj963 -
Pediatric Radiology Jun 2008Rhabdomyosarcoma (RMS) is the most common soft-tissue sarcoma of childhood. This paper is focuses on imaging for diagnosis, staging, and follow-up of noncraniofacial RMS. (Review)
Review
Rhabdomyosarcoma (RMS) is the most common soft-tissue sarcoma of childhood. This paper is focuses on imaging for diagnosis, staging, and follow-up of noncraniofacial RMS.
Topics: Adult; Child; Humans; Magnetic Resonance Imaging; Muscle Neoplasms; Positron-Emission Tomography; Radiography; Rhabdomyosarcoma; Thoracic Neoplasms; Tomography, X-Ray Computed; Ultrasonography; Urogenital Neoplasms
PubMed: 18324394
DOI: 10.1007/s00247-008-0751-y -
Journal of Vascular Surgery. Venous and... Mar 2017Intravenous leiomyomatosis is a benign smooth muscle tumor that often occurs in the internal iliac vein and is closely associated with a fibroid. Intravenous...
Intravenous leiomyomatosis is a benign smooth muscle tumor that often occurs in the internal iliac vein and is closely associated with a fibroid. Intravenous leiomyomatosis usually starts in the veins of the uterus. It can grow within the veins and extend into the inferior vena cava and ultimately extend into the right-sided heart chambers and pulmonary arteries. Other sites are less common, and a venous primary site is very rare. We report a case of subclavian vein tumor that was diagnosed as an unusual leiomyoma in a 21-year-old nulliparous woman.
Topics: Humans; Leiomyomatosis; Magnetic Resonance Angiography; Male; Multimodal Imaging; Muscle Neoplasms; Muscle, Smooth, Vascular; Positron Emission Tomography Computed Tomography; Subclavian Vein; Ultrasonography, Doppler, Color; Vascular Neoplasms; Young Adult
PubMed: 28214494
DOI: 10.1016/j.jvsv.2016.03.008